Li Ju, Wu Gang, Ji Wei-Feng, Tong Pei-Jian
Department of Orthopaedics, Hospital of TCM of Zhejiang Provice, Hangzhou 310006, Zhejiang, China.
Zhongguo Gu Shang. 2012 Jan;25(1):32-4.
To evaluate the clinical effects of ultra-early application with intermittent pneumatic compression (IPC) in preventing postoperative lower limbs deep venous thrombosis (DVT) of intertrochanteric fractures in elder patients.
From May 2008 to May 2010, 80 patients with intertrochanteric fractures were randomly divided into ultra-early group and postoperative group. In ultra-early group, there were 21 males and 19 females, ranging in age from 67 to 86 years with an average of (76.4 +/- 13.27) years; in postoperative group, there were 26 males and 14 females, ranging in age from 68 to 89 years with an average age (75.8 +/- 12.71) years. IPC was respectively used at the 3rd day before operation (ultra-early group) and postoperative that day (postoperative group). Serum D-dimer of all the patients were measured at the 3rd day before operation and at the 3rd, 7th,14th days after operation. Lower limbs DVT were observed by ultrasound at the 3rd, 14th days postoperatively. Perioperative bleeding volume of patients were compared between two groups.
There was no statistical difference in the serum D-dimer concentration and lower limbs DVT between two groups at the 3rd day before operation (P > 0.05). There was no statistical difference in perioperative bleeding volume between two groups (P > 0.05). In ultra-early group, Serum D-dimer concentration at the 3rd, 7th days after operation was respectively (351.00 +/- 104.34), (412.31 +/- 106.95) microg/ml; and in postoperative group, the item was respective (419.34 +/- 145.38), (509.16 +/- 146.05) microg/ml; serum D-dimer concentration in ultra-early group was lower than postoperative group (P < 0.05). There was no significant differences in serum D-dimer concentration at the 14th day after operation between two groups (P > 0.05). Incidence of DVT in postoperative group was 22.5%, which was higher than that of ultra-early group at the 14th day after operation (P < 0.05). There was no significant differences at the 3rd day after operation between two groups (P > 0.05).
Compared with postoperative application with IPC, ultra-early application with IPC could reduce the level of serum-dimer and the incidence of DVT without increase perioperative blood of intertrochanteric fracture in elder patients.
评估超早期应用间歇性充气加压（IPC）预防老年患者股骨粗隆间骨折术后下肢深静脉血栓形成（DVT）的临床效果。
2008年5月至2010年5月，80例股骨粗隆间骨折患者随机分为超早期组和术后组。超早期组男21例，女19例，年龄67～86岁，平均（76.4±13.27）岁；术后组男26例，女14例，年龄68～89岁，平均（75.8±12.71）岁。IPC分别于术前第3天（超早期组）和术后当天（术后组）使用。所有患者于术前第3天及术后第3、7、14天检测血清D-二聚体。术后第3、14天采用超声观察下肢DVT情况。比较两组患者围手术期出血量。
术前第3天两组患者血清D-二聚体浓度及下肢DVT发生率比较，差异无统计学意义（P＞0.05）。两组患者围手术期出血量比较，差异无统计学意义（P＞0.05）。超早期组术后第3、7天血清D-二聚体浓度分别为（351.00±104.34）、（412.31±106.95）μg/ml；术后组分别为（419.34±145.38）、（509.16±146.05）μg/ml；超早期组血清D-二聚体浓度低于术后组（P＜0.05）。术后第14天两组患者血清D-二聚体浓度比较，差异无统计学意义（P＞0.05）。术后组DVT发生率为22.5%，高于超早期组术后第14天（P＜0.05）。术后第3天两组比较，差异无统计学意义（P＞0.05）。
与术后应用IPC相比，超早期应用IPC可降低老年股骨粗隆间骨折患者血清二聚体水平及DVT发生率，且不增加围手术期出血量。
